Provider First Line Business Practice Location Address:
4001 S CHENEY-SPOKANE RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
SPOKANE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-455-5001
Provider Business Practice Location Address Fax Number:
509-891-2787
Provider Enumeration Date:
05/06/2014